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https://www.readbyqxmd.com/read/28625262/-predictive-value-of-sofa-score-combined-agi-grading-system-in-elderly-patients-with-sepsis-a-retrospective-analysis-with-91-patients
#1
Lingling Wang, Rui Chen, Zexun Mo, Jiahui Dong, Zhaokun Sun, Fei Xiao, Shaoting Hu, Richeng Xiong, Jie Sun, Zhou Yu, Zhenhui Guo
OBJECTIVE: To explore the predictive value of sequential organ failure assessment (SOFA) score combined the acute gastrointestinal injury (AGI) grading system in critical elderly patients with sepsis. METHODS: A retrospective analysis was conducted. Elderly patients with sepsis aged > 60 years admitted to medical intensive care unit (MICU) of General Hospital of Guangzhou Military Command from March 2014 to December 2015 and experiencing critical care over 48 hours were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28612034/effects-of-laser-polarization-on-responses-of-the-fluorescent-ca-2-indicator-x-rhod-1-in-neurons-and-myelin
#2
Ileana Micu, Craig Brideau, Li Lu, Peter K Stys
Laser-scanning optical microscopes generally do not control the polarization of the exciting laser field. We show that laser polarization and imaging mode (confocal versus two photon) exert a profound influence on the ability to detect [Formula: see text] changes in both cultured neurons and living myelin. With two-photon excitation, increasing ellipticity resulted in a [Formula: see text] reduction in resting X-Rhod-1 fluorescence in homogeneous bulk solution, cell cytoplasm, and myelin. In contrast, varying the angle of a linearly polarized laser field only had appreciable effects on dyes that partitioned into myelin in an ordered manner...
April 2017: Neurophotonics
https://www.readbyqxmd.com/read/28571498/preliminary-analysis-of-a-modified-screening-tool-to-increase-the-frequency-of-palliative-care-consults
#3
Emily Hurst, Lenar Yessayan, Michael Mendez, Aws Hammad, Jeffrey Jennings
PURPOSE: Palliative care interventions have been shown to improve patient quality of life but the benefit may be less if interventions occur late in the patient's disease process. The objective of this study was to evaluate whether an objective screening tool could improve the frequency and timeliness of palliative care consultation. METHODS: Using a quasi-experimental design with 2 geographically separate medical intensive care units (MICUs), the control MICU continued existing consultation practice and the intervention MICU implemented a screening tool with each new admission...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28570269/zinc-deficiency-primes-the-lung-for-ventilator-induced-injury
#4
Francis Boudreault, Miguel Pinilla-Vera, Joshua A Englert, Alvin T Kho, Colleen Isabelle, Antonio J Arciniegas, Diana Barragan-Bradford, Carolina Quintana, Diana Amador-Munoz, Jiazhen Guan, Kyoung Moo Choi, Lynette Sholl, Shelley Hurwitz, Daniel J Tschumperlin, Rebecca M Baron
Mechanical ventilation is necessary to support patients with acute lung injury, but also exacerbates injury through mechanical stress-activated signaling pathways. We show that stretch applied to cultured human cells, and to mouse lungs in vivo, induces robust expression of metallothionein, a potent antioxidant and cytoprotective molecule critical for cellular zinc homeostasis. Furthermore, genetic deficiency of murine metallothionein genes exacerbated lung injury caused by high tidal volume mechanical ventilation, identifying an adaptive role for these genes in limiting lung injury...
June 2, 2017: JCI Insight
https://www.readbyqxmd.com/read/28542272/factors-associated-with-poor-outcomes-of-continuous-renal-replacement-therapy
#5
Chih-Chin Kao, Ju-Yeh Yang, Likwang Chen, Chia-Ter Chao, Yu-Sen Peng, Chih-Kang Chiang, Jenq-Wen Huang, Kuan-Yu Hung
Continuous renal replacement therapy (CRRT) is one of the dialysis modalities for critically ill patients. Despite intensive dialysis care, a high mortality rate is found in these patients. Our objective was to investigate the factors associated with poor outcomes in these patients. We conducted a retrospective cohort study using the National Health Insurance Research Database. Records of critically ill patients who received CRRT between 2007 and 2011 were retrieved, and the patients were categorized into two groups: those with acute kidney injury (AKI) and those with history of end-stage renal disease (ESRD)...
2017: PloS One
https://www.readbyqxmd.com/read/28488929/mobile-diagnostic-units-for-rural-patients-in-colombia
#6
Luis Fernando Cifuentes
BACKGROUND: The literature on the use of mobile diagnostic units for the adult population is limited. This is a report for the first time in Colombia (Latin America) on the use of mobile diagnostic units for patients in rural areas and resolution of complex cases through telemedicine. INTRODUCTION: Telemedicine is an alternative because it takes advantage of advances in telecommunications and technology for the provision of health services to patients in rural areas of a country...
May 10, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28443390/an-integrative-index-for-predicting-extubation-outcomes-after-successful-completion-of-a-spontaneous-breathing-trial-in-an-adult-medical-intensive-care-unit
#7
Tsung-Ju Wu, Judith Shu-Chu Shiao, Hsin-Liang Yu, Ruay-Sheng Lai
BACKGROUND: Among respiratory predictors, rapid shallow breathing index (RSBI) has been a commonly used respiratory parameter to predict extubation outcomes. However, the outcome of prediction remains inconsistent. Regarding nonrespiratory predictors, serum albumin, hemoglobin, bicarbonate, and patients' alertness have been reported to be associated with successful weaning or extubation. We aimed to develop an integrative index combining commonly used predictors in the adult medical intensive care units (MICUs) and to compare the predictability of the index with RSBI...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28412642/impact-of-duration-of-hypotension-prior-to-norepinephrine-initiation-in-medical-intensive-care-unit-patients-with-septic-shock-a-prospective-observational-study
#8
Jayshil J Patel, Jonathan S Kurman, Ann Biesboer, Hasan Taha, Michael Katz, Aniko Szabo, Steven Q Simpson, Elizabeth R Jacobs
PURPOSE: To determine the impact of duration of hypotension prior to norepinephrine initiation on outcomes in MICU patients with septic shock. We hypothesized increased duration of hypotension prior to norepinephrine initiation would be associated with an increased risk for ICU mortality. MATERIALS AND METHODS: We conducted a prospective-observational study in the MICU of a single-center tertiary academic medical center. We enrolled 160 adults ≥18years old with septic shock...
April 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28392941/insulin-resistance-and-chronic-kidney-disease-in-patients-with-type-1-diabetes-mellitus
#9
Mihaela Vladu, Diana Clenciu, Ion Cristian Efrem, Mircea-Cătalin Forțofoiu, Anca Amzolini, Simona Tudorică Micu, Maria Moţa, Maria Forțofoiu
Background and Aims. Diabetes mellitus (DM) is a chronic disease which can evolve towards devastating micro- and macrovascular complications. DM is the most frequent cause of chronic kidney disease (CKD). Insulin resistance plays an important role in the natural history of type 1 diabetes. The purpose of the study was to determine the prevalence of CKD in T1DM and the correlation with insulin resistance (IR) in patients with CKD. Materials and Methods. The study was conducted over a period of three years (2010-2013) and included patients with DM registered in the Clinical Centre of Diabetes, Nutrition and Metabolic Diseases of Dolj county...
2017: Journal of Nutrition and Metabolism
https://www.readbyqxmd.com/read/28379571/safety-and-feasibility-of-a-protocolized-approach-to-in-bed-cycling-exercise-in-the-intensive-care-unit-quality-improvement-project
#10
Ibtehal Kimawi, Bryanna Lamberjack, Archana Nelliot, Amy Lee Toonstra, Jennifer Zanni, Minxuan Huang, Earl Mantheiy, Michelle E Kho, Dale M Needham
Background: : In-bed, supine cycle ergometry as a part of early rehabilitation in the intensive care unit (ICU) appears to be safe, feasible, and beneficial, but no standardized protocol exists. A standardized protocol may help guide use of cycle ergometry in the ICU. Objective: We investigated whether a standardized protocol for in-bed cycling is safe and feasible, and results in cycling for a longer duration and achieves a higher resistance. Design: A quality improvement (QI) project was conducted...
March 31, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28357623/impact-of-pharmaceutical-care-on-pain-and-agitation-in-a-medical-intensive-care-unit-in-thailand
#11
Pitchaya Dilokpattanamongkol, Viratch Tangsujaritvijit, Thanarat Suansanae, Chuthamanee Suthisisang
Background Currently, a lack of pharmaceutical care exists concerning pain and agitation in medical intensive care units (MICU) in Thailand. Pharmaceutical care focusing on analgesics/sedatives would improve clinical outcomes. Objective To investigate the impact of pharmaceutical care of pain and agitation on ICU length of stay (LOS), hospital LOS, ventilator days and mortality. Setting The MICU of a university hospital. Method A before/after study was conducted on mechanically ventilated patients receiving analgesics/sedatives...
March 29, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28338247/impact-of-diabetic-ketoacidosis-management-in-the-medical-intensive-care-unit-after-order-set-implementation
#12
Benjamin Laliberte, Siu Yan Amy Yeung, Jeffrey P Gonzales
OBJECTIVE: To determine the rate of compliance to the 2006 and 2009 ADA DKA guidelines in the medical intensive care unit (MICU) at a large academic medical centre after the implementation of a computerised DKA order set and protocol. METHODS: Retrospective chart review of adult patients with DKA admitted to the MICU. Results of pre-order set (PRE) were compared to those of data post-order set (POST). The primary outcome was a composite administration of intravenous fluid resuscitation in the first 24 h, insulin bolus and initial insulin infusion rate...
June 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28285400/how-does-environmental-variation-affect-the-distribution-of-dragonfly-larvae-odonata-in-the-amazon-cerrado-transition-zone-in-central-brazil
#13
T P Mendes, A Luiza-Andrade, H S R Cabette, L Juen
This study investigated the effects of environmental variation on assemblages of dragonfly larvae (Odonata). We hypothesize that there is a significant correlation between species richness, species composition, and abundance of Odonata individuals, and habitat integrity and abiotic variables. To test this hypothesis, we sampled odonate larvae at 12 streams in the Suiá-Miçú River basin in Mato Grosso, Brazil, during three different periods of the year. Local physical and chemical variables (temperature, pH, turbidity, electrical conductivity (EC), dissolved oxygen (DO), total dissolved solids (TDS), and oxidation reduction potential (ORP)) were measured at each site using a multi-parameter probe, and integrity was assessed using the Habitat Integrity Index (HII)...
March 11, 2017: Neotropical Entomology
https://www.readbyqxmd.com/read/28285068/reducing-unnecessary-laboratory-testing-in-the%C3%A2-medical-icu
#14
Nisha Kotecha, Janet M Shapiro, John Cardasis, Gopal Narayanswami
No abstract text is available yet for this article.
March 9, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28279496/outcomes-of-nighttime-refusal-of-admission-to-the-intensive-care-unit-the-role-of-the-intensivist-in-triage
#15
Nicholas Hinds, Amit Borah, Erika J Yoo
PURPOSE: To compare outcomes of patients refused medical intensive care unit (MICU) admission overnight to those refused during the day and to examine the impact of the intensivist in triage. MATERIALS AND METHODS: Retrospective, observational study of patients refused MICU admission at an urban university hospital. RESULTS: Of 294 patients, 186 (63.3%) were refused admission overnight compared to 108 (36.7%) refused during the day. Severity-of-illness by the Mortality Probability Model was similar between the two groups (P=...
June 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28273989/healthcare-associated-infections-in-a-resource-limited-setting
#16
Chanaveerappa Bammigatti, Saikumar Doradla, Harish Narasimha Belgode, Harichandra Kumar, Rathinam Palamalai Swaminathan
INTRODUCTION: Health Care associated Infections (HAI) are the most common complications affecting the hospitalized patients. HAI are more common in developing and under developed countries. However, there are no systematic surveillance programs in these countries. AIM: To find out the burden, predisposing factors and multidrug resistant organisms causing HAI in a resource limited setting. MATERIALS AND METHODS: This prospective observational study was done at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER)...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28250136/definition-and-reliability-assessment-of-elementary-ultrasonographic-findings-in-calcium-pyrophosphate-deposition-disease-a-study-by-the-omeract-calcium-pyrophosphate-deposition-disease-ultrasound-subtask-force
#17
Georgios Filippou, Carlo A Scirè, Nemanja Damjanov, Antonella Adinolfi, Greta Carrara, Valentina Picerno, Carmela Toscano, George A Bruyn, Maria Antonietta D'Agostino, Andrea Delle Sedie, Emilio Filippucci, Marwin Gutierrez, Mihaela Micu, Ingrid Möller, Esperanza Naredo, Carlos Pineda, Francesco Porta, Wolfgang A Schmidt, Lene Terslev, Violeta Vlad, Pascal Zufferey, Annamaria Iagnocco
OBJECTIVE: To define the ultrasonographic characteristics of calcium pyrophosphate crystal (CPP) deposits in joints and periarticular tissues and to evaluate the intra- and interobserver reliability of expert ultrasonographers in the assessment of CPP deposition disease (CPPD) according to the new definitions. METHODS: After a systematic literature review, a Delphi survey was circulated among a group of expert ultrasonographers, who were members of the CPPD Ultrasound (US) Outcome Measures in Rheumatology (OMERACT) subtask force, to obtain definitions of the US characteristics of CPPD at the level of fibrocartilage (FC), hyaline cartilage (HC), tendon, and synovial fluid (SF)...
March 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28191374/klebsiella-pneumoniae-liver-abscess-a-case-report-and-review-of-literature
#18
Faisal Kamal, George Williams, Hina Akbar, Muhammad Ali Khan, Dipen Kadaria
Klebsiella pneumoniae (K.pneumoniae) is a known cause of pyogenic liver abscess (PLA) in the absence of hepatobiliary disease. In settings of hepatic infection, it has also been known to cause disseminated infections including meningitis and endopthalmitis. Several groups of patients are particularly susceptible to infection, including patients with diabetes mellitus, those from Southeast Asia and those with the preexisting hepatobiliary disease. We present a case of K.pneumoniae PLA with bacteremia. A 39-year-old Vietnamese male with no previous medical history who presented with complaints of abdominal pain, nausea, vomiting, diarrhea and fever...
January 10, 2017: Curēus
https://www.readbyqxmd.com/read/28127691/toxic-metals-in-tissues-of-fishes-from-the-black-sea-and-associated-human-health-risk-exposure
#19
Gabriel Plavan, Oana Jitar, Carmen Teodosiu, Mircea Nicoara, Dragos Micu, Stefan-Adrian Strungaru
The anthropogenic activities in the Black Sea area are responsible for toxic metal contamination of sea food products. In this study, several toxic metals: cadmium, lead, nickel, chromium, and copper were quantified in different tissues (digestive tract, muscle, skeleton, skin) of nine fish species (Neogobius melanostomus, Belone belone, Solea solea, Trachurus mediterraneus ponticus, Sardina pilchardus, Engraulis encrasicolus, Pomatomus saltatrix, Sprattus sprattus, Scorpaena porcus) by using atomic absorption spectrometer with a high-resolution continuum source and graphite furnace technique (HR-CS GF-AAS), and the risk of fish meat consumption by the young human population was evaluated...
March 2017: Environmental Science and Pollution Research International
https://www.readbyqxmd.com/read/28042074/a-communications-bundle-to-improve-satisfaction-for-critically-ill-patients-and-their-families-a-prospective-cohort-pilot-study
#20
Rana L Awdish, Dana Buick, Maria Kokas, Hanan Berlin, Catherine Jackman, Cari Williamson, Michael P Mendez, Kristen Chasteen
CONTEXT: Communication skills training with simulated patients is used by many academic centers, but how to translate skills learned in simulated settings to improve communication in real encounters has not been described. OBJECTIVES: We developed a communications bundle to facilitate skill transfer from simulation to real encounters and improve patient and/or family satisfaction with physician communication. We tested the feasibility of its use in our hospital's medical intensive care unit (MICU)...
March 2017: Journal of Pain and Symptom Management
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